A GOP ‘assault’ on women’s health?

“In order to pay for it, [House Republicans] are going to make an assault on women’s health, make another assault on women’s health, continue our assault on women’s health and pay for this with prevention initiatives that are in effect right now for childhood immunization; for screening for breast cancer, for cervical cancer; and for initiatives to reduce birth defects – a large part of what the Center for Disease Control does in terms of prevention.”

--House Minority Leader Nancy Perlosi (D-Calif.), April 26, 2012

“I’ll guarantee you that they’ve not spent a dime out of this fund dealing with anything to do with women’s health.”

--House Speaker John Boehner (R-Ohio), April 30, 2012

This is why Americans hate politics. How can two serious, major-league politicians have such a vehement disagreement over even basic facts?

At dispute is how to provide funding that would prevent a jump in the interest rates for subsidized loans made by the federal government to undergraduate college students. The House of Representatives voted last week to keep the rate from doubling, but funded it by eliminating the Prevention and Public Health Fund that is part of President Obama’s health care law. (The House measure has little chance in the Senate controlled by Democrats.)

There is a bit of budget gamesmanship going on here, as well as a relentless messaging campaign by the Democrats. Just look at some of these quotes:

--“The only way they can find to pay for it is to attack women’s health and children’s health” (Rep. John Tierney of Massachusetts).

--“Under the cover of being for student loans, they now are attacking women’s health in the most cynical fashion.” (Rep. George Miller of California.)

--“The way to pay for this assistance for students is not to shut down health for the women of this country.” (Rep. Rob Andrews of New Jersey).

We are not going to get into an argument about whether the preventive health fund is a good or bad thing — Democrats say it provides steady funding for preventive health, Republicans say it is a “slush fund” to get around regular appropriations — but we do think it would be useful to examine how much money in this fund goes to women’s health programs.

The Facts

First of all, it makes a difference whether you look at the current fiscal year (2012) or proposals for the next fiscal year (2013). In the current fiscal year, there is very little money specifically allocated to women’s health programs.

Take a look at this list on the Department of Health and Human Services website, and you will see there is nothing specifically aimed at women, except perhaps $7 million for breastfeeding. Pelosi mentioned childhood immunization, and that’s there, but that’s more for children than women. But cervical cancer, breast cancer, birth defects — nope, unless you label programs on obesity and tobacco as preventing birth defects.

Indeed, a year ago, when the White House decried a previous effort by Republicans to kill the fund, its official statement made no mention of women’s health. “By concentrating on the causes of chronic disease, the Affordable Care Act helps move the Nation from a focus on sickness and disease to one based on wellness and prevention,” the statement said.

Women make up about 50 percent of the population, so what Democrats are doing is essentially relabeling preventive health programs aimed at all Americans as affecting primarily women. A fact sheet provided by Pelosi spokesman Drew Hammill made that case, arguing that “a higher proportion of women of child-bearing age are overweight or obese compared to men and women of younger or older ages.” He said that some 60 percent of the $1 billion in the fund for 2012 “benefit women and their children.”

Moreover, Hammill said that Pelosi was not trying to say these programs were in the fund now, only that they exist currently and would be funded through the fund in the future.

We are not sure if that is clear from her comments. Boehner spokesman Brendan Buck, meanwhile, says that the speaker “was responding to Democratic charges about cutting breast and cervical cancer” services when he said not “a dime” in the fund went to women’s health. “If you want to take his literal meaning to go beyond the breast and cervical cancer that he was asked about, I concede that 0.7% of funding has gone to a women-specific program (breastfeeding),” Buck said. “But if he was exaggerating, it clearly wasn’t by a whole lot.”

Still, the picture gets more complicated when you consider fiscal 2013 funding. That’s because, in President Obama’s budget, the administration proposed moving $260 million in funding for cervical and breast cancer prevention into the fund. It’s only a proposal, but that is why administration officials defend raising the women’s health issue in a statement on the more recent legislation.

“Women, in particular, will benefit from this Prevention Fund, which would provide for hundreds of thousands of screenings for breast and cervical cancer,” the statement said.

(Note the use of the word “will”.)

“For FY 2013, the Administration has felt forced to propose PPHF funding for certain large, indispensable prevention programs that it hasn’t proposed PPHF funding before – such as the breast and cervical cancer screenings for women program and the program to prevent and detect birth defects – in order to save these programs and ensure they continue to exist,” Hammill said. “They have been forced to do this because since January 2011 House Republicans have been systematically working to cut the vital Labor-HHS-Education appropriations bill.”

However, we think an ordinary person would think Pelosi’s remarks made it seem as if the funding proposed for 2013 is actually happening right now. It’s unclear if the administration’s plan will be accepted by Congress, but budgetary stalemate actually works to Obama’s advantage. If the Congress is unable to allocate the funds based on its own priorities, that authority passes to the administration, as it did for the 2012 fiscal year. (That, in effect, is how the fund gets labeled “a slush fund” — Congress gave up its authority.)

Hammill argues that women are more adversely affected by cuts to government programs, and so it makes sense to keep the focus on the impact on women. He forthrightly defended the use of the phrase “assault,” saying “One would have to be living under a rock not to notice a clear assault on women and children under the Republican leadership.”

“I don’t think this is a gray area,” he said. “I think we are on solid ground here. ...Leader Pelosi’s statement is clear and factual.”

The Pinocchio Test

This is a good example of politicians using obscure details of the budgetary process to score political points.

From Pelosi’s statement, one could imagine a wholesale “assault” to strip funding for women’s health programs. But in fact, there are virtually no specific programs aimed at women currently in the fund. In the future, the administration hopes to add such programs, but that is not the reality today, as evidenced by the fact the administration never raised this concern last year when the GOP-led House also voted to kill the preventive health care fund.

Pelosi could have raised concerns about perceived cuts in preventive health. She could have also noted that women benefit greatly from such efforts. But she — and fellow Democrats — went too far to label this “an assault on women’s health.” Maybe evidence of that will emerge through the regular appropriations process—at which point we could revisit this ruling — but for the moment this smacks of political opportunism.

We wavered between one and two Pinocchios but ultimately this fits with two on our scale: “Some factual error may be involved but not necessarily. A politician can create a false, misleading impression by playing with words and using legalistic language that means little to ordinary people.”

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